title: Effective surgical treatment of the carotid sinus sindrome.
abstract: Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.
authors.affiliation: Department of Surgery, Máxima Medical Centre , Veldhoven, The Netherlands. r.toorop@mmc.nl
authors.forename: R J
authors.initials: RJ
authors.lastname: TOOROP
authors.forename: M R M
authors.initials: MR
authors.lastname: SCHELTINGA
authors.forename: M H M
authors.initials: MH
authors.lastname: BENDER
authors.forename: J A
authors.initials: JA
authors.lastname: CHARBON
authors.forename: M C
authors.initials: MC
authors.lastname: HUIGE
authors.forename: F L
authors.initials: FL
authors.lastname: MOLL
authors.forename: C M A
authors.initials: CM
authors.lastname: BRUIJNINCKX
mesh_terms: D000368:Aged; D017763:Autonomic Denervation; D017704:Baroreflex; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D002346:Carotid Sinus / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013577:Syndrome; D016896:Treatment Outcome